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Not back to birth weight at two weeks

My two week old son had his two week visit with the pediatrician today. He only gained one ounce during the past week! (Birth weight = 6lbs15ozs, left hospital at 6lbs6ozs and weighed in at 6lbs 11ozs at one week visit.) We've had latching issues from day one and I had sore cracked nipples. Learned the laid back nursing position and things improved. Now this! Doctor wants me to pump and give breast milk via bottle every other time he wants to nurse and she wants me to increase my caloric and fluid intake to improve quality of my milk. I have to take him back for a weigh in this Friday. He grew .75" since last week and his head circumference increased by .75" since last week. Any words of advice? Is my baby getting enough milk? How much should I worry, if at all?

Re: Not back to birth weight at two weeks

My twins were below their birth weight at three weeks. I was terrified. They were so thin! Their problem was sleepiness. Is your baby getting in very many feedings? He should be getting 8-12 in a 24-hour period (preferably 12 or more!). Mine had jaundice, so they really just wanted to sleep all the time. The key for us was waking them up. All the time. At first I was waking them up after about 90 minutes during the day and every 3 hours at night. We encouraged them to eat all the time, and finally they took to it and started nursing in 5-hour stretches. The day they turned pink was the day I realized how bad their jaundice really had been. Definitely read this article on babies getting enough milk: http://www.llli.org/faq/enough.html

If your baby is seeming to get enough milk now and your pain is gone, then I would hold off on the bottle advice. It's possible he's just now getting the hang of nursing.

Re: Not back to birth weight at two weeks

My son had/has jaundice, too. He's still a little yellow, but doctor didn't comment on it during his visit so I didn't even think about it, but you're right sleepiness is an issue. He falls asleep at the breast and its hard to rouse him, but I'll start trying harder now!! There's still some pain when he latches but its gotten much better so I want to think you're right, that he's just starting to get the hang of it. Thank you!!

Re: Not back to birth weight at two weeks

Yes the jaundice is definitely one of the main culprits. Mine had it too and he was just so sleepy all.the.time. It's almost impossible to wake him. Stripping him, changing diaper, tickling, etc would not do the trick. I had to make use of his fussy times (that's when he's awake) to cram in a boob. And lc also told me jaundice babies are usually very sleepy. Well, mine survived. He's now an extremely active 16 month old. I'm sure yours is going to be ok too!

Re: Not back to birth weight at two weeks

My first son was not back to his birth weight even after 3 weeks. He had jaundice, too, so the sleepiness was a big factor. An IBCLC was seeing us, and she eventually put a bunch of signs he was showing together (as well as some symptoms I reported, like clicking noises and sandpaper feeling while nursing); he had a posterior tongue tie. This was at 5 weeks, I was horribly mangled on both nipples at this point and he had not gained much weight.

We went and got him looked at by an ENT and he confirmed the tongue tie, clipped it, and literally (I am not exaggerating) the improvement was immediate. It took about a week for my nipples to heal, but the pain relief was immediate. My son also started gaining weight finally. He is over 2 years old now and is in the 50% for weight and 75% for height after spending his first month falling down to the 10% from the upper 80's (he was born 8lbs 10oz).

When we were struggling through the sleepiness I used to nurse him, then hand him off to my mom and pump both sides, then my mom or my husband would give him what I pumped. This seemed to help him get more milk in while also maintaining my supply!

Re: Not back to birth weight at two weeks

It is important to look at: How many times baby has been nursing each day, and also output-how are baby's poops? is nursing now comfortable for you? Are you limiting the length of nursing sessions at all?

IN the newborn period a baby must nurse at least 10-12 times in 24 hours.

If your baby has been nursing less than that each day, I would suggest asking your doctor if you can increase the number of nursing sessions instead of pumping and bottles, or increase nursing sessions and pump and bottle feed but a little less than doctor suggests maybe. Its not that the pumping and bottles is such a bad idea, it's not. It may increase your baby’s milk intake. But so may simply nursing more frequently and/or helping baby nurse more effectively. I would also get clarity on what the doctor wants to see by the Friday weight check. AVERAGE gain in this period after two weeks of age is about an ounce a day, but many babies gain less than that per day but are doing fine.
Also, do not panic. Your baby IS gaining and growing. This can get figured out!

Re: Not back to birth weight at two weeks

Thank you all! Going to see an LC tomorrow as I think part of the issue is he's not nursing efficiently, still having latching issues. Another LC I saw on day 5 after my son was born said his frenulum is a little restricted and she recommends clipping but his pediatrician does not recommend. So I'm not sure how to proceed on that front. Am hoping that with time and practice and help from an LC he will get better at latching and sucking and nursing in general. He is at the breast at least 10-12 times per 24 hours, cluster feeding, but he falls asleep at the breast pretty quickly and it is very hard to rouse him but I am trying everything. I pumped twice today and got two ounces each time and gave him that in a bottle. He's pooping and peeing the right amount according to article one of you referred me to and other articles I've read thru LLLI. This is very stressful and I appreciate your support!